Provider Demographics
NPI:1417639907
Name:SCHWEICKERT, EMILY HIVICK (PA-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:HIVICK
Last Name:SCHWEICKERT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:HIVICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2611 W MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-1600
Mailing Address - Country:US
Mailing Address - Phone:540-221-6702
Mailing Address - Fax:
Practice Address - Street 1:2611 W MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-1600
Practice Address - Country:US
Practice Address - Phone:540-221-6702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-03
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA363A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant